Leaving a nursing job in Minnesota after allegations of misconduct was never much of a problem for Kathryn Idovich. She always found another one.

Six times in 12 years, in fact.

By the time the Minnesota Board of Nursing suspended Idovich's license last December, Idovich's employment history included a patient injury under her watch, medication errors, unauthorized lookups of patient records and reporting to work after drinking, records show.

A Star Tribune review of Nursing Board disciplinary actions since 2010 found that at least 173 caregivers lost jobs after allegations of misconduct and managed to find new nursing positions. That includes nurses who have been found responsible for maltreating children and vulnerable adults, stolen drugs from their workplaces, practiced while impaired, or whose care has to led to harm of their patients.

Neither the Nursing Board nor Idovich's former employers would discuss how she was able to lead such a long career, despite events — four firings, five drunken-driving convictions and failing state sobriety monitoring — that were cited as justification for her license suspension last year.

"There were a number of instances, and such a long pattern," said Deb Holtz, the state's ombudsman for long-term care. Holtz reviewed Idovich's records for the Star Tribune. "There didn't seem to be any critical point in the system, where someone or something said, 'This is enough.' "

In an interview last month, Idovich, 39, who lives in northern Minnesota, attributed her job turnover to false accusations, bad luck and a desire to do different kinds of nursing care. She said she is ready to return to practice after being sober since April 2012.

"I have letters from my employers saying I was at work on time, that I was working hard and responsible," she said.

By law, employers are supposed to tell the Nursing Board when they fire a nurse. But the Nursing Board has not used its power to sanction employers for failing to do so.

Nurses who have lost jobs most often find work in the high-demand areas of aging care, group homes and home health care, disciplinary records show. Patti Cullen, the president of Care Providers of Minnesota, a trade group of more than 600 long-term care providers in the state, acknowledged that troubled nurses are working in her industry.

Cullen blamed holes in the state's background check system and employers' fear of defamation lawsuits from former employees for enabling problem nurses to quickly find new jobs. Cullen reviewed Idovich's case for the Star Tribune and said she did not believe any of her members would hire Idovich "if they knew any of this."

"She fell through the cracks," Cullen said. "There were a lot of protections that were built in to protect the innocent that also protect those that are chronic offenders."

A career in nursing

Idovich obtained an LPN license in 1997 without disclosing that she had been convicted of drunken driving four years earlier or that she had abused alcohol, according to a Nursing Board report.

Two years later, in 1999, Idovich was working at a group home when a picture frame fell on a resident in her care, she said. The injury near his eye required stitches. Idovich was fired.

The Star Tribune could not determine whether Idovich's group home employer, or any of her employers since then, complied with the 1989 law requiring reporting of terminations to the Nursing Board, because those reports are shielded from public view.

A law passed last year allows the Nursing Board to levy a fine against any employer that violates this law. The board has not investigated any employer for failing to report, according to Nursing Board Executive Director Shirley Brekken.

In 2003, Idovich applied for an RN license and did not disclose she had a history of alcohol abuse or that she had been fired from a job, according to the Nursing Board report.

She went to work for a hospital, which Idovich said was the most stressful place she has worked. According to the Nursing Board, Idovich resigned from the hospital after being told about concerns regarding medication errors, blood administration and communication.

Idovich went to work for a Brainerd home health care company in 2003, then resigned in April 2004. According to the Nursing Board, she cashed a check from the home of a client without authorization. Idovich said she was falsely accused by the company and did nothing wrong.

In 2006, Idovich was fired from a dialysis company. According to the board, she did not report for duty. Idovich said she lost her job after she called in sick.

At the end of 2009, Idovich was fired from MeritCare in Bemidji after she repeatedly accessed patients' and colleagues' medical records without authorization, according to the Nursing Board report. Idovich told the Star Tribune she only accessed her children's records. "I didn't know you couldn't do that," she said.

Caring for seniors

Idovich then began working for Heritage Community, a senior-care facility in Park Rapids managed by Ecumen. She was at Heritage for about a month before a co-worker smelled alcohol on her breath. She said she refused to take a toxicology screen.

Idovich said she wasn't scheduled to come in to work that day, had "a few beers" and then got called in.

"I wasn't doing any patient cares until I helped somebody with a patient," she said. "Somebody must have smelled it and called the director."

Idovich said the policy of the home was to refer employees with substance-abuse problems to treatment, rather than fire them. She said she called a state monitoring program for addicted or mentally ill health care professionals and reported her alcohol abuse and treatment history. Idovich enrolled in March 2010, but the Health Professionals Services Program did not have to alert the Nursing Board.

Reprimanded

In April 2010, Idovich was contacted by the Nursing Board for what appears to be the first time and asked to respond to her firing for accessing patient records at MeritCare. The Nursing Board issued a reprimand and ordered Idovich to pay a $750 fine.

The Nursing Board report does not indicate whether it looked into her previous firings and DWIs.

That was a glaring error, according to Melissa Becker, a registered nurse and a legal nurse consultant who reviewed Idovich's case for the Star Tribune.

"The Board of Nursing relies too much on self-reporting," Becker said. "If you're simply looking for self-disclosure, you're going to fail."

In January 2011, Idovich was fired from Heritage Community for "failing to complete necessary paperwork for her leave of absence," according to the Nursing Board report. Idovich said she was fired after she requested a leave due to a pregnancy and an illness, and Heritage learned she was looking for other work.

"Luckily, Neilson Place ended up hiring me," she said.

That facility, a nursing home in Bemidji, took Idovich on in February 2011, at least her seventh nursing job in 12 years.

In September of that year, she was discharged from the state monitoring program for noncompliance after submitting three untestable drug screens. She denied drinking while under state monitoring.

In January 2012, Idovich said the Nursing Board told her she would be able to keep her license, but then in April 2012 she was charged with her fifth DWI, a felony.

She pleaded guilty to the charge and was sentenced to 180 days in jail. In December 2012, the board suspended her license, for the first time indicating that they knew her full history of job losses and alcohol abuse.

"If you get a DWI, the board will take every action to help you keep your license," she said. "But if you get a felony one, it's different."

Since then, Idovich said, she has worked at a grocery store and cleaned hotel rooms. She said she wanted to be a nurse assistant, but the felony DWI disqualified her from providing direct care.

She said she's a good nurse who put her patients first, and is continually working to stay sober, including attending Alcoholics Anonymous once a week. Idovich is now eligible to petition to get her license back, which she said she plans to do.

Brandon Stahl • 612-673-4626